Ashoka
The first Ashoka Fellow in Finland and co-founder of Kukunori, Markus Raivio, is leading the way for a functional peer support mindset in mental health care.
Mental healthcare, both across the world and in Finland, operates on the assumption that a therapist’s and doctor`s framework and way of treating conditions determines the method of recovery. This way of thinking can leave clients feeling powerless in their recovery and can risk overshadowing patients’ identities with their diagnoses. Mental health and substance use disorders affect 13% of the world's population. That number could increase as people worldwide shelter in place and adjust to a new normal amid the coronavirus pandemic. 970 million people worldwide have a mental health or substance abuse disorder. (Our World in Data, 2018) Is there really enough therapists to solve this epidemic through traditional care only?
Kukunori was established in 2012 with the aim to redesign mental healthcare – focusing on co-creative partnerships that support individuals’ skills and interests. From the start, Kukunori has created widespread impact within social entrepreneurship in Finland through partnerships and connections between mental health associations. Kukunori connects 43 Finnish non-profits supporting wellbeing, arts, and culture while also reducing inequality.
According to Markus Raivio, Finland’s mental health sector still embraces traditional approaches to care. This approach is based on the assumption that a trained professional is necessarily best suited to interact people with mental health issues. Moreover, Markus believes that mental health professionals’ assessment of someone’s ability to function too often focuses on what the evaluator considers important, based on their own training and preferred approach, rather than on the client’s needs and dreams. The power dynamic embedded in this leaves those dealing with serious mental health challenges with little sense of agency to recover and reintegrate into communities and workplaces.
Markus Raivio is determined to change this dynamic, and has worked on it for more than a decade. His approach reshapes traditional therapist-patient dynamics into client-led collaborations and reallocates the resources for recovery.
Markus and his team have designed a co-creative framework of mental health care, which is the foundation for the Guided Peer Support model (GFP). In this open source model, mental health clients are participating in training programs to tutor functional groups to each other. The peer tutors are trained by professionals to support clients in groups. Instead of focusing on problems, the clients do and learn new things that they are interested in together. The contents of the functional groups are usually art-based and include for example music, multimedia and visual arts, but activities with animals and sports are also common.
An innovative combination of proven theories from occupational therapy, human development, and special education, GFP focuses first on hope and recovery by creating spaces called 'Culture Houses' in which clients, who are mainly transitioning from institutionalized to outpatient care, tutor and learn from each other based on personal strengths and interests.
The model is a consolidation of peer support and functional activities with the aim to support mental health clients. GFP as a framework is not an anti-psychiatry movement, quite the opposite. The model gives clients methods to find suitable ways of life management and to improve their social skills through culture and art. It is center framework for 16 culture houses in Finland and Sweden run by eight NGO`s.
Markus’ ability to bridge partnerships between mental health associations and to use culture and arts as a tool for transforming mental health care demonstrates his natural role as a changemaker and Ashoka’s first fellow ever elected in Finland. Kukunori is inspiring social entrepreneurship across Finland and shifting the mental health care system, including how patients and therapists perceive and treat mental health challenges.
Personal transformation as a driver for systemic change in mental healthcare
The origin of Kukunori’s powerful social impact lies in Markus Raivio’s own experiences and personal journey. As a youth living in Pori Finland, Markus became troubled during a time when his grandmother’s schizophrenia was treated with invasive procedures. He was since then driven to make a change to support mental health treatments that respect an individual’s rights and wellbeing.
While, overcoming the troubles he experienced in his neighborhood growing up and dropped out from school, Markus discovered music. Two paths converged, as both his natural affinity for music and drive to envision more empathetic mental health care led to his organization and current work. His changemaking work was later inspired by his time working as a music therapist in mental health wards. Here, he came to the realization that a client’s skills and strengths can be developed to help guide their own care. For example, when clients play a musical instrument or choose a type of music for another client to listen, this creates a space where they can abandon the patient identity that often limits and conceals individual skills and agency.
Markus’ initiative to rethink traditional therapist-patient power dynamics is evident by the way GFP creates an environment where clients struggling with anxiety, depression and other mental health challenges can co-create and learn from each other. This method allows for mental health care professionals to take on the role of facilitator instead of therapist.
From collaboration to transformation: Kukunori’s co-creative treatments to improve patient outcomes
One of the main goals of the GFP method is to support clients in retaining the skills and agency to rejoin their communities and field of work. Markus’ focus on clients regaining their normal lives is a foundation for his organization and the influence it has on other organizations. This type of work aligns with Ashoka’s Everyone a Changemaker vision because of its focus on long-term versus short-term goals, supporting clients in regaining a sense of purpose to address root causes of mental health challenges instead of short-term fixes.
According to Ashoka`s research, Kukunori’s social impact is also evident in GFP’s focus on the lived experience, which has led to psychiatric wards in Helsinki hospitals marking a positive shift in the way staff interact with clients as well as improved treatment outcomes.
As a changemaker, Markus is actively contributing towards systems change by reframing how therapy and clinical care are perceived and practiced. Rather than focusing on deficits, the focus is placed on skillsets and the power of collaboration for sharing knowledge and supporting each other’s wellbeing. His inspiring story is an example of how co-creative social change is often first rooted in personal transformation.
The Ashoka Fellowship
Ashoka Fellows are the world’s leading social entrepreneurs who champion innovative ideas to transform society’s systems. Do you know - or are you yourself - someone with a path-breaking new idea who is approaching problem-solving in an entrepreneurial and creative way? Read more about the Ashoka Fellowship and Nominate a Changemaker here.